National Healthcare Quality and Disparities Report
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Topics
- Alcohol Use (1)
- Antibiotics (1)
- Care Management (1)
- Children/Adolescents (12)
- Communication (1)
- Community-Based Practice (2)
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- Comparative Effectiveness (1)
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- Racial and Ethnic Minorities (3)
- Research Methodologies (1)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 20 of 20 Research Studies DisplayedLiu S, Matvekas A, Naimi T
Morphomics-informed population pharmacokinetic and physiologically-based pharmacokinetic modeling to optimize cefazolin surgical prophylaxis.
This study’s objective was to use algorithms that repurpose radiologic data into body composition (morphomics) to aid in informing dosing decisions for the antibiotic cefazolin for patients undergoing colorectal surgery who have obesity. This prospective study measured cefazolin plasma, fat, and colon tissue concentrations in these patients to develop a morphomics-informed population pharmacokinetic (PopPK) model to guide dose adjustments. A physiologically-based pharmacokinetic (PBPK) model was also constructed to inform tissue partitioning in 21 morbidly obese patients (body mass index ≥35 kg/m2 with one or more co-morbid conditions). Morphomics and pharmacokinetic data were available in 58 patients with a median weight of 95.9 kg and and 55 years, respectively. The plasma-to-subcutaneous fat partition coefficient was predicted to be 0.072 for the PopPK model and 0.060 for the PBPK model. Covariates of cefazolin exposure were identified as the estimated creatinine clearance (eCL(cr) ) and body depth at the third lumbar vertebra (body depth_L3). The authors concluded that kidney function and morphomics were more informative than body weight as covariates of cefazolin target site exposure. They advised that data from more diverse populations, consensus on target cefazolin exposure, and comparative studies are needed before a change in practice can be implemented.
AHRQ-funded; HS027183.
Citation: Liu S, Matvekas A, Naimi T .
Morphomics-informed population pharmacokinetic and physiologically-based pharmacokinetic modeling to optimize cefazolin surgical prophylaxis.
Pharmacotherapy 2024 Jan; 44(1):77-86. doi: 10.1002/phar.2878..
Keywords: Surgery, Antibiotics, Medication, Prevention, Obesity, Healthcare-Associated Infections (HAIs)
Wang ML, Minyé HM, Egan KA
Community-based sugar-sweetened beverage intervention associated with short-term improvements in self-rated oral health.
The purpose of this study was to assess the efficacy of a community-based childhood obesity prevention intervention targeting sugar-sweetened beverage (SSB) consumption on self-rated oral health among children and their parents/caregivers. The investigators found that short-term improvements in oral health among children and their parents/caregivers were observed among those participating in a SSB behavioural intervention.
AHRQ-funded; HS022242.
Citation: Wang ML, Minyé HM, Egan KA .
Community-based sugar-sweetened beverage intervention associated with short-term improvements in self-rated oral health.
Community Dent Oral Epidemiol 2021 Aug;49(4):362-68. doi: 10.1111/cdoe.12610..
Keywords: Children/Adolescents, Obesity, Dental and Oral Health, Prevention
Payán DD, Derose KP, Flórez KR
The food environment in 3 neighborhoods in South Los Angeles, California: access, availability, quality, and marketing practices.
The authors developed a mapping component as part of a multilevel church-based intervention that used community-based participatory research to prevent obesity in African American and Latino churches in South Los Angeles. They developed neighborhood maps of local food environments and provided churches with standardized information on food access, availability, quality, and marketing practices. Including several tables as well as discussion, they stated that local food environment maps that are paired with data can inform community-based strategies to prevent obesity and food insecurity.
AHRQ-funded; HS000046.
Citation: Payán DD, Derose KP, Flórez KR .
The food environment in 3 neighborhoods in South Los Angeles, California: access, availability, quality, and marketing practices.
Prev Chronic Dis 2020 Jul 16;17:E61. doi: 10.5888/pcd17.200028.
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Keywords: Obesity, Racial and Ethnic Minorities, Prevention, Prevention, Community Partnerships, Community-Based Practice, Nutrition
Flórez KR, Payán DD, Palar K
Church-based interventions to address obesity among African Americans and Latinos in the United States: a systematic review.
This systematic literature review examined the impact of multilevel church-based interventions to address racial/ethnic disparities in obesity in the US. The review identified 43 relevant articles using systematic review methods developed by the CDC’s Task Force on Community Preventive Services. Although 81% of the studies reported significant results, effective size was reported or could only be calculated in 56% of the cases. A lack of diversity among the samples was also found with few studies involving Latinos, men, young adults, or children. Few interventions were actually multilevel in nature or incorporated strategies at the church or community. Greater diversity is needed in future church-based interventions.
AHRQ-funded; HS000046.
Citation: Flórez KR, Payán DD, Palar K .
Church-based interventions to address obesity among African Americans and Latinos in the United States: a systematic review.
Nutr Rev 2020 Apr;78(4):304-22. doi: 10.1093/nutrit/nuz046..
Keywords: Racial and Ethnic Minorities, Obesity, Obesity: Weight Management, Disparities, Health Promotion, Prevention
Carlson NS, Breman R, Neal JL
Preventing cesarean birth in women with obesity: influence of unit-level midwifery presence on use of cesarean among women in the Consortium on Safe Labor data set.
The primary goal of this study was to examine associations between midwifery unit-level presence and unplanned cesarean birth in women with different body mass index (BMI) ranges. Data from the Consortium on Safe Labor was used to analyze information on low-risk, healthy women who labored and gave birth in medical centers with or without the unit-level presence of midwives. Results indicate that the odds of unplanned cesarean birth among women who gave birth in centers with midwives were 16% lower than the odds of cesarean birth among similar women who gave birth at centers without midwives. However, women whose BMI was above 35.00 kg/m at labor admission had similar odds of cesarean birth, regardless of unit-level midwifery presence. Although integration of midwives into the caregiving environment of medical centers in the United States was associated with overall decrease in the incidence of cesarean birth, increased maternal BMI nevertheless remained positively associated with these outcomes.
AHRQ-funded; HS024733
Citation: Carlson NS, Breman R, Neal JL .
Preventing cesarean birth in women with obesity: influence of unit-level midwifery presence on use of cesarean among women in the Consortium on Safe Labor data set.
J Midwifery Womens Health 2020 Jan;65(1):22-32. doi: 10.1111/jmwh.13022..
Keywords: Labor and Delivery, Pregnancy, Obesity, Women, Prevention, Maternal Care
Shafer PR, Borsky A, Ngo-Metzger Q
AHRQ Author: Shafer PR, Borsky A, Ngo-Metzger Q, Miller T, Meyers D
The practice gap: national estimates of screening and counseling for alcohol, tobacco, and obesity.
The authors of this study estimated screening and counseling rates for tobacco and alcohol use, and obesity by using a nationally representative sample of adults aged 35 years and older. Receipt of the recommended level of services ranged from nearly two-thirds for obesity and tobacco use to less than half for alcohol misuse. The authors conclude that care delivery shows significant room for improvement, but primary care practices may need additional resources to raise their screening and counseling rates.
AHRQ-authored.
Citation: Shafer PR, Borsky A, Ngo-Metzger Q .
The practice gap: national estimates of screening and counseling for alcohol, tobacco, and obesity.
Ann Fam Med 2019 Mar;17(2):161-63. doi: 10.1370/afm.2363..
Keywords: Alcohol Use, Lifestyle Changes, Obesity, Prevention, Primary Care, Screening, Substance Abuse, Tobacco Use
Bramante CT, Thornton RLJ, Bennett WL
Systematic review of natural experiments for childhood obesity prevention and control.
This article reviews the effectiveness of population-level policies and programs from natural experiments for childhood obesity prevention. A search of PubMed, CINAHL, PsycINFO, and EconLit from 2000 to 2017 sought studies about policies evaluated by natural experiments reporting childhood BMI outcomes. Interventions were classified by environmental focus and stratified by setting; risk of bias was evaluated for each study. Most of the studies evaluated took place in a school setting. The most common environmental focus in any setting was food/beverage. All four of the studies that focused on food/beverage and physical activity in schools showed decreased prevalence of overweight/obesity in the subjects. BMI decreased in all four studies in both school and community settings. The authors note that while school-based policies focusing on both food/beverage and physical activity environments showed consistent improvement in BMI, most of these studies had high risk of bias. Improved methods for the evaluation of natural experiments for childhood obesity prevention are needed.
AHRQ-funded; 290201200007I.
Citation: Bramante CT, Thornton RLJ, Bennett WL .
Systematic review of natural experiments for childhood obesity prevention and control.
Am J Prev Med 2019 Jan;56(1):147-58. doi: 10.1016/j.amepre.2018.08.023..
Keywords: Children/Adolescents, Evidence-Based Practice, Obesity, Obesity: Weight Management, Prevention
Bennett WL, Wilson RF, Zhang A
Methods for evaluating natural experiments in obesity: a systematic review.
The researchers identified studies that report effects of programs, policies, or built environment changes on obesity prevention and control and described their methods. They found many methodologically diverse natural experiments and experimental studies that reported effects of U.S. and non-U.S. programs, policies, or built environment changes on obesity prevention and control, reinforcing the need for methodological and analytic advances to strengthen evaluations of obesity prevention and control initiatives.
AHRQ-funded; 290201200007I.
Citation: Bennett WL, Wilson RF, Zhang A .
Methods for evaluating natural experiments in obesity: a systematic review.
Ann Intern Med 2018 Jun 5;168(11):791-800. doi: 10.7326/m18-0309.
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Keywords: Obesity, Patient-Centered Outcomes Research, Prevention, Research Methodologies
Quattrin Wilfley, DE
The promise and opportunities for screening and treating childhood obesity: USPSTF recommendation statement.
This editorial discusses the updated recommendation statement and evidence review released by the United States Preventive Services Task Force (USPSTF) on screening for obesity in children. The Task Force recommendations are called ‘a call to arms’ against a condition that has immediate as well as long-term consequences for the health of the children affected. The authors note that the evaluation techniques for screening for obesity carry very few risks. Family-based behavioral treatment and the effectiveness of behavioral interventions, as well as pharmacotherapies, are also discussed.
AHRQ-funded; HS022816.
Citation: Quattrin Wilfley, DE .
The promise and opportunities for screening and treating childhood obesity: USPSTF recommendation statement.
JAMA Pediatr 2017 Aug;171(8):733-35. doi: 10.1001/jamapediatrics.2017.1604..
Keywords: Children/Adolescents, Guidelines, Obesity, Prevention, Screening, U.S. Preventive Services Task Force (USPSTF)
Gance-Cleveland B, Aldrich H, Dandreaux D
A virtual childhood obesity collaborative: satisfaction with online continuing education.
This descriptive study evaluated school-based health center (SBHC) providers’ satisfaction with Web based continuing education as part of a virtual childhood obesity intervention. Participation in the first two learning sessions was higher than the last two. Provider satisfaction of training modules by question type and content area was quite high. Many providers also reported plans to make changes in their practice after completing the training.
AHRQ-funded; HS018646.
Citation: Gance-Cleveland B, Aldrich H, Dandreaux D .
A virtual childhood obesity collaborative: satisfaction with online continuing education.
J Pediatr Health Care 2015 Sep-Oct;29(5):413-23. doi: 10.1016/j.pedhc.2015.01.006..
Keywords: Education: Continuing Medical Education, Obesity, Children/Adolescents, Prevention, Web-Based
Shaikh U, Romano P, Paterniti DA
Organizing for quality improvement in health care: An example from childhood obesity prevention.
The researchers evaluated how the quality improvement (QI) intervention, Healthy Eating Active Living TeleHealth Community of Practice, at 7 rural California clinics addressed the challenges. of preventing and managing obesity and translation of evidence into practice. Key challenges were clinician and staff buy-in, changing ingrained clinical practices, and motivating patient and families. Facilitators included top-down organizational requirements for QI, linkages to local QI resources, and involvement of clinical champions.
AHRQ-funded; HS018567.
Citation: Shaikh U, Romano P, Paterniti DA .
Organizing for quality improvement in health care: An example from childhood obesity prevention.
Qual Manag Health Care 2015 Jul-Sep;24(3):121-8. doi: 10.1097/qmh.0000000000000066.
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Keywords: Quality Improvement, Children/Adolescents, Obesity, Prevention, Primary Care
Wang Y, Cai L, Wu Y
What childhood obesity prevention programmes work? A systematic review and meta-analysis.
The researchers systematically evaluated the effectiveness of childhood obesity prevention programs conducted in high-income countries and implemented in various settings. Their review found at least moderately strong evidence supporting the effectiveness of school-based interventions involving physical activity, diet or combined diet and physical activity for preventing childhood obesity.
AHRQ-funded; 290200710061I.
Citation: Wang Y, Cai L, Wu Y .
What childhood obesity prevention programmes work? A systematic review and meta-analysis.
Obes Rev 2015 Jul;16(7):547-65. doi: 10.1111/obr.12277..
Keywords: Children/Adolescents, Comparative Effectiveness, Obesity, Prevention
Leeman J, Myers AE, Ribisl KM
Disseminating policy and environmental change interventions: insights from obesity prevention and tobacco control.
This paper describes the approach that two projects developed to disseminate policy and environmental change interventions. The Center for Training and Research Translation (Center TRT) disseminates evidence-based interventions (EBIs) to promote physical activity and healthy eating. Counter Tobacco disseminates EBIs to counter tobacco product sales and marketing in the retail environment.
AHRQ-funded; HS019468.
Citation: Leeman J, Myers AE, Ribisl KM .
Disseminating policy and environmental change interventions: insights from obesity prevention and tobacco control.
Int J Behav Med 2015 Jun;22(3):301-11. doi: 10.1007/s12529-014-9427-1..
Keywords: Communication, Evidence-Based Practice, Obesity, Policy, Prevention, Public Health, Tobacco Use, Implementation
Yun L, Boles RE, Haemer MA
A randomized, home-based, childhood obesity intervention delivered by patient navigators.
This paper delineates the study protocol for the Community Outreach Obesity Prevention Trial. COOPT is an ongoing, 4-year (October 2011-September 2015) randomized controlled trial that tests the effectiveness of a home-based patient navigator program delivered to preschoolers of a large urban safety-net health care system. The researchers believe that its home-based intervention venue will provide rich data characterizing barriers and facilitators to healthy behavior change within the home.
AHRQ-funded; HS021138.
Citation: Yun L, Boles RE, Haemer MA .
A randomized, home-based, childhood obesity intervention delivered by patient navigators.
BMC Public Health 2015 May;15:506. doi: 10.1186/s12889-015-1833-z..
Keywords: Children/Adolescents, Community-Based Practice, Obesity, Prevention, Racial and Ethnic Minorities
Gance-Cleveland B, Aldrich H, Schmiege S
Clinician adherence to childhood overweight and obesity recommendations by race/ethnicity of the child.
This study describes school-based health center (SBHC) providers’ adherence to obesity guidelines. Providers (n = 28) were from SBHCs in six states serving children 5–12 years of age. Body mass index percentage was documented on 73 percent of charts and blood pressure percentage on 30.5 percent. Providers accurately diagnosed 40 percent overweight and 49.3 percent obese children.
AHRQ-funded; HS018646.
Citation: Gance-Cleveland B, Aldrich H, Schmiege S .
Clinician adherence to childhood overweight and obesity recommendations by race/ethnicity of the child.
J Spec Pediatr Nurs 2015 Apr;20(2):115-22. doi: 10.1111/jspn.12107..
Keywords: Children/Adolescents, Guidelines, Obesity, Prevention
Cai L, Wu Y, Cheskin LI
Effect of childhood obesity prevention programmes on blood lipids: a systematic review and meta-analysis.
This study, the first systematic, quantitative study of childhood obesity prevention programs on blood lipids in high-income countries found that most interventions (70 percent) showed similar significant or no effects on adiposity- and lipid outcomes; 15 percent of interventions improved both adiposity- and lipids outcomes; 55 percent had no significant effects on either. These programs had a significant desirable effect on LDL-C and HDL-C.
AHRQ-funded; 290200710061I
Citation: Cai L, Wu Y, Cheskin LI .
Effect of childhood obesity prevention programmes on blood lipids: a systematic review and meta-analysis.
Obes Rev. 2014 Dec;15(12):933-44. doi: 10.1111/obr.12227..
Keywords: Children/Adolescents, Obesity, Prevention, Outcomes, Social Determinants of Health
Shaikh U, Nettiksimmons J, Joseph JG
Collaborative practice improvement for childhood obesity in rural clinics: the Healthy Eating Active Living Telehealth Community of Practice (HEALTH COP).
The authors assessed the impact of participation in a virtual quality improvement (QI) learning network on adherence to clinical guidelines for childhood obesity prevention in rural clinics. They found that children who received care from clinicians who led the implementation of the intervention at their clinic showed significant improvements in nutrition and physical activity. Virtual QI learning networks in geographically dispersed clinics can significantly increase clinicians' adherence to guidelines for childhood obesity and improve access to recommended care for rural and underserved children.
AHRQ-funded; HS018567.
Citation: Shaikh U, Nettiksimmons J, Joseph JG .
Collaborative practice improvement for childhood obesity in rural clinics: the Healthy Eating Active Living Telehealth Community of Practice (HEALTH COP).
Am J Med Qual 2014 Nov-Dec;29(6):467-75. doi: 10.1177/1062860613506252.
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Keywords: Children/Adolescents, Evidence-Based Practice, Health Information Technology (HIT), Lifestyle Changes, Nutrition, Obesity, Prevention, Quality Improvement, Rural Health, Telehealth
Aldrich H, Gance-Cleveland B, Schmiege S
Identification and assessment of childhood obesity by school-based health center providers.
The authors evaluated obesity care assessment practices of school-based health center (SBHC) providers prior to completing training on obesity guidelines. They found that most providers reported using BMI to assess weight, reported screening for hypertension 100% of the time and cardiovascular disease 93.9% of the time, and approximately two thirds reported requesting total cholesterol and lipid profile laboratory assessments.
AHRQ-funded; HS018646.
Citation: Aldrich H, Gance-Cleveland B, Schmiege S .
Identification and assessment of childhood obesity by school-based health center providers.
J Pediatr Health Care 2014 Nov-Dec;28(6):526-33. doi: 10.1016/j.pedhc.2014.05.002.
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Keywords: Children/Adolescents, Guidelines, Education, Obesity, Prevention
Aldrich H, Gance-Cleveland B, Schmiege S
School-based health center providers' treatment of overweight children.
The purpose of this study was to determine self-reported treatment practices of school-based health center (SBHC) providers when caring for overweight/obese children. SBHC providers reported patient/parent barriers to be more significant to treatment than clinician/setting barriers. Most providers (97%) indicated childhood overweight needs treatment, yet only 36% indicated that they initiate treatment in children who do not want to control their weight. SBHC providers also did not commonly refer these children to specialists.
AHRQ-funded; HS018646.
Citation: Aldrich H, Gance-Cleveland B, Schmiege S .
School-based health center providers' treatment of overweight children.
J Pediatr Nurs 2014 Nov-Dec;29(6):521-7. doi: 10.1016/j.pedn.2014.05.007.
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Keywords: Care Management, Children/Adolescents, Education, Obesity, Prevention, Obesity: Weight Management
Leeman J, Teal R, Jernigan J
What evidence and support do state-level public health practitioners need to address obesity prevention.
This study describes interview and survey findings that detail how public health practitioners characterize the obesity prevention task, the types of evidence and support they find most helpful, and their needs for additional evidence and support. The researchers conducted 10 in-depth interviews with public health practitioners and project officers followed by an online survey completed by 62 practitioners.
AHRQ-funded; HS019468.
Citation: Leeman J, Teal R, Jernigan J .
What evidence and support do state-level public health practitioners need to address obesity prevention.
Am J Health Promot 2014 Jan-Feb;28(3):189-96. doi: 10.4278/ajhp.120518-QUAL-266..
Keywords: Obesity, Prevention, Public Health